Our objective was to assess the impact of echo-Doppler technique on the diagnosis of Deep Vein Thrombosis (DVT) in major orthopedic surgery (80% of DVT diagnosed are asymptomatic). We therefore analyzed 200 consecutive pts submitted to elective surgery for total hip replacement. The postoperative echo-Doppler study indicated DVT in 13 pts: these pts underwent a postoperative lower limb phlebography. Echo-Doppler and phlebography had concordant results in 11 of 13 echo assessed proximal DVT. These observations suggest that Duplex scanning is a good method to diagnose and to guide therapy for proximal DVT in orthopaedic clinic.

Anticoagulants↗

PubMedDate not supplied

Electromagnetic fields in the treatment of postmenopausal osteoporosis: an experimental study conducted by densitometric, dry ash weight and metabolic analysis of bone tissue.

The authors conducted an experimental study on 32 female rats which had been castrated at 10 months of age in order to verify the ability of pulsating electromagnetic fields to prevent osteoporosis induced by surgical menopause. Two different values of intensity of PEMFs were used: 30 G and 70 G. After 4 months of treatment the following testing was done: monophotonic bone densitometry of the lumbar spine, quantitative measurement of the dry ash weight of the femurs, and hematochemical tests to evaluate bone metabolism. The experimental study showed that the PEMFs supplied at 30 Gauss were capable of slowing down the loss of bone mass, while the PEMFs supplied at 70 Gauss obstructed bone decay, providing values for Bone Mineral Density and dry ash weight which were very similar to those observed in the non-castrated control group. Hematochemical tests did not reveal significant variations between the two groups.

Animals↗

PubMedDate not supplied

Evaluation of an experimental model of osteoporosis induced in the female rat through ovariectomy.

The present paper intends to check the possibility of improving convenience of the osteoporosis model from ovariectomy in the rat by anticipating the operation to the 40th week rather than the 52nd week of age, thought by some authors to be the optimum model. To this end two parameters have been examined: 1. the bone mass variation determined with the vertebral photon densitometer and weighing of the femur ashes; 2. the chemico-crystallographic characteristics of the bone determined through chemical analysis and X-ray diffractometry. The results obtained induce us to believe that ovariectomy carried out on rats of 40 or 52 weeks of age determine bone mass losses that are statistically comparable. The variations in the dry bone weight/ash bone weight ratio are superposable and the structural chemical characteristics, due to the increase in bone turnover are testified by the increase in osteocalcin. Moreover, it was observed that the most reliable evaluation of bone mass loss can be obtained with the vertebral photon densitometry. Thus, it is thought that the model which foresees ovariectomy of rats 40 weeks after birth compared with those operated 52 weeks after birth, represents a good model of osteoporosis from estrogen deficiency which, due to the evident practical advantages deriving from the use of younger animals it associates a decrease in the use of laboratory animals with statistically reliable results.

Absorptiometry, Photon↗

PubMedDate not supplied

[A prospective study on nephrotoxicity induced by continuous infusion of high-dose ifosfamide (15/m2)].

BACKGROUND: A good response rate to high-dose ifosfamide (HDIFO) has been reported in metastatic osteosarcoma and soft tissue tumors. As standard dose of IFO (< 12 g/m2) can give several renal complications and patients previously treated with nephrotoxic drugs are at high risk of nephrotoxicity, a prospective study to evaluate the pattern of nephrotoxicity induced by HDIFO was carried out. METHODS: Twelve patients (11 metastatic osteosarcoma, 1 synovial sarcoma; mean age 17, R 14-34) were treated with 4 courses of HDIFO/ MESNA (15 g/m2, IV 5 day continuous infusion with bicarbonate and K supplements). All but two were previously treated with cisplatin and methotrexate. Several parameters of renal function were measured before treatment, after each HDIFO course and two months after chemotherapy completion. RESULTS: Significant changes in the urinary excretion of beta 1-microglobulin, beta 2-microglobulin, Alanine Aminopeptidase, N-Acetil-beta, D-glucosaminidase and a significant reduction in phosphate tubular absorbtion according to the cumulative dose of IFO infused, were observed. Phosphaturia and hypophosphatemia occurred in all the patients studied. In 5 patients, CrCl fell below 70 ml/min with normal serum creatinine level after 45 g/m2 IFO. Plasma bicarbonate concentration less than 20 mmol/l was observed in 5 of 48 HDIFO courses. Glycosuria was detected in 4 patients. Two months after chemotherapy completion, mild glycosuria and slightly reduced CrCl persisted in two patients, whereas the other parameters of renal function studied were similar to the baseline values. An acute, usually reversible subclinical nephrotoxicity involving glomerule and renal tubule was demonstrated in all the patients treated with HDIFO. A persisting subclinical renal impairment was shown with mild glycosuria (2/12 patients) and slightly reduced CrCl (2/12 patients).

Adolescent↗